Toxicity of Androgen Deprivation Therapy in Hormone-Sensitive Prostate Cancer

Androgen deprivation therapy for prostate cancer is one of the most effective types of systemic therapies in solid tumor malignancies and represents one of the first examples of “targeted therapy.” However, we have become increasingly aware of the adverse events associated with androgen deprivation therapy. Some of these side effects can have deleterious effects on quality of life, and others may contribute to increased risks for serious health concerns. Vasomotor toxicity (hot flashes) and sexual side effects are among the most well-recognized adverse effects. Additional toxicities related to the metabolic effects include bone and muscle changes, lipid and glucose metabolic changes, and cognitive changes, which are important to recognize. Physicians should be aware of profound effects of ADT and should incorporate strategies for preventing, identifying, and managing toxicities into routine practice. This chapter reviews the incidence and mechanism of each group of toxicities and discusses the potential primary and secondary therapeutic possibilities.